A device (100) for creating a tunnel through soft tissue, comprises an elongated insertion member including a lumen extending therethrough to a distal opening, the elongated insertion member being sized to be inserted into the body via an opening of no more than 35 mm diameter and a tunneling member (108) received in the lumen for movement between an insertion configuration in which a tissue penetrating distal tip is received within the lumen and a tunneling configuration in which the distal tip extends distally from the distal opening by a desired distance in combination with a handle (104) coupled to a proximal end of the insertion member, the handle remaining outside the body and including a first actuator (106) for moving the tunneling member between the insertion and tunneling configurations.